Provider Demographics
NPI:1770752024
Name:PLATTE VALLEY FOOT AND ANKLE CLINIC P.C.
Entity type:Organization
Organization Name:PLATTE VALLEY FOOT AND ANKLE CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:YAKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-659-5950
Mailing Address - Street 1:36 S 18TH AVE STE H
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-2452
Mailing Address - Country:US
Mailing Address - Phone:303-659-5950
Mailing Address - Fax:303-654-0948
Practice Address - Street 1:36 S 18TH AVE STE H
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2452
Practice Address - Country:US
Practice Address - Phone:303-659-5950
Practice Address - Fax:303-654-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO537213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01005370Medicaid
COU61283Medicare UPIN
CO0355360001Medicare NSC
COC52333Medicare PIN